Clinical Oncology in Sri Lanka: Embracing the Promise of the Future.

Sri Lanka is an island-nation in South Asia with a population of 22.2 million people, and a predominantly public funded state health system which is free at the point of delivery. Cancer is now the second leading cause of hospital mortality and registry data show a trend of increasing incidence. Cancers of the head and neck, lung, oesophagus, colon and prostate are the commonest among males, while breast, thyroid, uterine cervix, ovary and colon are more prevalent in females. While there is relatively good funding for many systemic therapies including monoclonal antibodies and small molecules, a shortage of both trained specialists and radiotherapy equipment has made the delivery of radiotherapy challenging for most patients. Since only three functioning linear accelerators and nine cobalt teletherapy units are currently available, the government has initiated a programme to expand radiotherapy resources in the country. Although the future prospects are promising, clinical oncologists will have to meet the challenge of ensuring cost-effective and evidence based health care.